Tuberculosis in schools: an outbreak in northeastern Italy and some key health protection interventions

• Published in: Croatian Medical Journal Vol. 62; no. 1; pp. 90 - 94
• Main Authors: Cegolon, Luca, Mastrangelo, Giuseppe, Gentili, Davide, Mastromarino, Mario, Cegolon, Andrea, Pichierri, Giuseppe, Cinquetti, Sandro, Bellizzi, Saverio, Sotgiu, Giovanni
• Format: Journal Article Web Resource
• Language: English
• Published: Croatia Sveuciliste U Zagrebu 01.02.2021; Medicinski fakultet Sveučilišta u Zagrebu, Medicinski fakultet Sveučilišta u Splitu, Medicinski fakultet Sveučilišta u Rijeci; Croatian Medical Schools
• Subjects: Drug therapy; Elementary schools; Epidemics; Health aspects; Infection control; Italy; Methods; Statistics; Tuberculosis; Italy
• ISSN: 0353-9504; 1332-8166
• DOI: 10.3325/CMJ.2021.62.90

In April 2019, a tuberculosis (TB) outbreak, likely triggered by re-activation of a highly contagious latent tuberculosis infection (LTBI) in a school teacher, was reported in a primary school in the Veneto Region (northeastern Italy). The infection, having probably been dormant for decades, rapidly spread further to two school teachers and up to 11 pupils, a total of 13 cases of active TB that received appropriate TB treatment. Ten out of the remaining 95 school staff members (10.5%) and 34/546 (6.2%) remaining school pupils tested positive on tuberculin skin test (TST). Moreover, 2% (2/97) of pupils attending the first year of junior secondary school within the same municipality during 2017/18 (having completed the above primary school) were also found positive on TST. Since none of 3 school teachers or 84 pupils who completed the last year of primary school in 2017 and attended the second year of a junior secondary school were found to be TST positive, the beginning of the outbreak was dated from January 2018 onwards. Therefore, active TB in the index case may have been potentially infectious and undiagnosed for about 14 months, leading to extensive exposure of close contacts, especially students (1). Anyone with recognized LTBI status – among school staff or pupils – was placed on prophylaxis with isoniazid for 6 months (1).